The first advance over standard chemo for platinum-resistant patients, with an antibody conjugate that saves months of life
A new drug is set to change the current standard of ovarian cancer care because it is superior to traditional chemotherapy in achieving several goals, starting with the most important: extend patient survival which, specifically, they have platinum-resistant ovarian cancer and expressing high levels of alpha-folate receptor. To say it are the results of the MIRASOL study presented at the annual meeting of the American Society of Clinical Oncology (Asco) in progress in Chicago and judged as particularly promising by the many experts present. “It is the first medicine, after 20 years of waiting, which manages to lengthen the survival of women with a platinum-resistant neoplasm – underlines Nicoletta Colombo, director of the Oncological Gynecology Program at the European Institute of Oncology (IEO) in Milan and lead author of the study —. We had a great need that we couldn’t fill and this is the first step up from standard chemotherapywith which the average survival of women is about a year (when platinum resistance arises), now it reaches a year and a half ».
Six months of extra life: why they matter
In short, you earn six months. Aren’t they few? “Many researches have been conducted, but none until now has ever managed to prolong the life of patients with platinum-resistant ovarian cancer (which is generally the most effective chemotherapy against this type of cancer) – he replies Sandro Pignata, director of uro-gynecological medical oncology at the Pascale Cancer Institute in Naples, who participated in the study —. Of course, six months may seem short, but these are average values and many women included in the study with this new drug benefited from more time. In the end, these are steps forward that in any case give us hope of being able to obtain further advantages in the earlier stages of the disease, as has already happened with other medicines ». For example, anticipating the administration of the new drug (mirvetuximab soravtansine), which participants in the MIRASOL trial were given as a second, third or fourth line of treatment.
A difficult tumor
Still considered today one of the most difficult tumors to cure among gynecological neoplasms, ovarian cancer affects about 5,200 women every year in Italy alone, with 3,000 deaths per yearalso because the diagnosis is late in 80% of cases, given that the disease it does not cause specific symptoms in the initial stages. For this reason, experts always use a lot of caution when talking about new treatments, but some important progress has finally been made in recent years.
The experimentation (phase three, the last before definitive approval of a new treatment), in fact, recruited 453 women with platinum-resistant ovarian cancer expressing folate receptor alpha (a protein that contributes to tumor growth) who had already received one to three courses of therapy: 14% had done only one, 39% two and 47% three. Their tumor was therefore in an advanced stage or already metastatic. 62% of previous treatments had been the drug bevacizumab and for 55% a Parp inhibitor. The patients were then treated or with chemotherapy or with mirvetuximab soravtansine and the results of the study indicate that the median survival was approximately 12 months with the chemo and nearly 18 with the new treatment. «About 30% of women with ovarian cancer express folate alpha receptor, it is therefore a niche – explains Colombo -, but on the basis of these data we expect an ok from the European regulatory agency EMA (in the US it has already received accelerated approval).
Care well tolerated
Moreover, the new drug was well tolerated, with a toxicity that did not worsen the quality of life of the patients because the side effects, which mainly affected the eyes and the gastrointestinal tract, can be managed without much difficulty. «Mirvetuximab soravtansine is a latest generation medicine, which is part of the family of conjugated antibodiesalready in use against various solid and blood cancers – he concludes Lorusso Sundayassociate professor of oncological gynecology at the Catholic University of the Sacred Heart in Rome, another Italian representative of the trial —: it is molecules that combine a monoclonal antibody capable of identifying cancer cells with high specificity with a chemotherapy that is responsible for destroying them». When the neoplasm is detected in the initial stage (i.e. when it is limited to the ovaries) the 5-year survival chance is 75-90%, but if the tumor has already spread to other organs and with the presence of metastases, the situation is much more complex. It is important not to overlook possible alarm bells, albeit very vague ones, such as: feeling of satiety even on an empty stomach; persistent bloating in the abdomen; abdominal pain; frequent need to urinate; vaginal bleeding; persistent constipation or diarrhea.
June 5, 2023 (change June 5, 2023 | 11:40 am)
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